Measuring the positive psychological well-being of people with rheumatoid arthritis: a cross-sectional validation of the subjective vitality scale

Introduction: People with rheumatoid arthritis (RA) frequently suffer from compromised physical and psychological health, however, little is known about positive indicators of health, due to a lack of validated outcome measures. This study aims to validate a clinically relevant outcome measure of positive psychological well-being for people with RA. The first study examined the reliability and factorial validity of the Subjective Vitality Scale (SVS), whilst study 2 tested the instruments convergent validity. Methods: In study 1, National Rheumatoid Arthritis Society members (N = 333; M age = 59.82 years SD = 11.00) completed a postal questionnaire. For study 2, participants (N = 106; M age = 56 years, SD = 12 years) were those recruited to a randomized control trial comparing two physical activity interventions who completed a range of health-related questionnaires. Results: The SVS had a high level of internal consistency (α = .93, Rho = .92). Confirmatory factor analysis supported the uni-dimensional factor structure of the questionnaire among RA patients [χ = 1327 (10), CFI = 1.0, SRMSR = .01 and RMSEA = .00 (.00 - .08)]. Support for the scales convergent validity was revealed by significant (p < .05) relationships, in expected directions, with health related quality of life (r = .59), physical function (r = .58), feelings of fatigue (r = −.70), anxiety (r = −.57) and depression (r = −.73). Conclusions: Results from two studies have provided support for the internal consistency, factorial structure and convergent validity of the Subjective Vitality Scale. Researchers and healthcare providers may employ this clinically relevant, freely available and brief assessment with the confidence that it is a valid and reliable measure of positive psychological well-being for RA patients

Model-dependent pharmacokinetic analysis of enalapril administered to healthy adult volunteers using orodispersible minitablets for use in pediatrics

Muhammad Faisal,* Willi Cawello,* Bjoern B Burckhardt, Stephanie Laer On behalf of LENA Consortium Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich-Heine-University D&uuml;sseldorf, D&uuml;sseldorf, Germany *These authors contributed equally to this work Introduction: Comparative pharmacokinetic (PK) data analysis of drugs administered using developed child-appropriate and market authorized dosage formulation is sparse and is important in pediatric drug development. Objectives: To compare and evaluate any differences in PK of enalapril administered using two treatments of child-appropriate orodispersible minitablets (ODMTs) and market authorized reference tablet formulation (Renitec&reg;) using PK compartment model and validated least square minimization method (LSMM) of parameter estimation. Methods: Full profile data sets were obtained from a phase I clinical trial, whereby three treatments of enalapril, ie, reference tablets with 240 mL water (treatment A), child-appropriate ODMTs with 240 mL (treatment B), and ODMTs dispersed in the mouth with 20 mL water (treatment C), were administered to 24 healthy adult volunteers. Virtual validation analysis was conducted using R program to select accurate and precise LSMM of parameter estimation. For the selection of PK model and estimation of parameters, enalapril data were fitted with one- and two-compartment models with first order of absorption and elimination, with and without incorporated lag time parameter (tlag). The log-transformed PK parameters were statistically compared by the two-sided paired t-test with the level of significance of P&lt;0.05. Results: One-compartment model with first-order absorption and elimination and incorporated lag time adequately predicted concentrations of enalapril. Reciprocal of predicted concentration using iteratively reweighted LSMM was selected as the most appropriate method of parameter estimation. Comparison of PK parameters including rate constant of absorption and elimination, volume of distribution, and tlag between the three treatments showed significant difference (P=0.018) in tlag between treatments B and A only. Conclusion: Compared with reference formulation, enalapril administered from child-appropriate ODMTs administered with 240 mL water appeared 4 minutes earlier in serum. No other differences were observed in absorption, elimination, and relative bioavailability of drug between the three treatment arms. Keywords: enalapril, orodispersible minitablets, least square minimization method, child-appropriate dosage forms, model-dependent pharmacokinetic

The Development of an Educational Video on Blood Pressure Measurement for Pharmacy Students

Samieh Farahani,1 Imaneh Farahani,1 Bjoern B Burckhardt,1 Karin Monser,2 Stephanie Laeer1 1Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Duesseldorf, Germany; 2Multimedia Center, Heinrich Heine University Duesseldorf, Duesseldorf, GermanyCorrespondence: Samieh FarahaniInstitute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, Duesseldorf, 40225, GermanyEmail [email protected]: High blood pressure is an important worldwide health issue. Pharmacists can perform multifaceted tasks in hypertension management such as measuring blood pressure. In a time where the use of educational videos in health professions education has increased, an educational video might be an option for teaching blood pressure measurement skills to pharmacy students. This project aimed to develop an educational video tailored to pharmacy students on oscillometric blood pressure measurement in a community pharmacy setting that can be used as a self-instruction video.Methods: The video was created with support from the university&rsquo;s multimedia center. The video development was roughly divided into pre-production, production, and post-production. Students&rsquo; satisfaction with and perception of the video was surveyed.Results: An 11-minute 33-second self-instruction video in the German language on proper oscillometric blood pressure measurement tailored for pharmacy students was created. Along with descriptive slides, the video delineates the necessary steps of blood pressure measurement in a community pharmacy setting in a role-play, to support students in communication with the patient. Results of a survey on the satisfaction and perception of the video from thirty-seven pharmacy students were included in the analysis and revealed that the video was well accepted by pharmacy students. Moreover, approximately 95% responded that instructional videos should be included in future pharmacy education.Conclusion: We successfully developed an educational video on oscillometric blood pressure measurement for a community pharmacy setting. This work is a valuable form of support for faculty members, who intend to develop educational videos. This might be of interest especially during the coronavirus disease 2019 (COVID-19) pandemic, where distance learning has become highly relevant.Keywords: pharmacy, pharmacy education, pharmacy students, educational video, self-instruction video, blood pressure measuremen

Efeitos do condicionamento físico sobre pacientes com fibromialgia Efectos del condicionamiento físico en pacientes con fibromialgia Effects of physical conditioning over patients with fibromyalgia

INTRODUÇÃO: Fibromialgia é uma síndrome crônica, caracterizada por dor músculo-esquelética generalizada. A possibilidade de atenuação dos sintomas com a atividade física abriu novas perspectivas para o tratamento desta doença. OBJETIVO: Avaliar o efeito de um programa de condicionamento físico sobre a capacidade funcional, dor e qualidade de vida de pacientes com fibromialgia. MÉTODOS: Adotado o desenho de coorte para avaliar 18 mulheres, média de 46,4 &plusmn; 5,8 anos de idade, com a síndrome em média de 10,6 &plusmn; 5,7 anos, submetidas a um ano de condicionamento físico supervisionado, predominantemente aeróbio. No início do estudo e trimestralmente foram realizados: teste de esforço cardiopulmonar para determinação da capacidade funcional; avaliação da intensidade de dor empregando a escala analógica visual; contagem dos pontos dolorosos e determinação do limiar de dor à pressão com o uso do algômetro de pressão; aplicação do questionário de qualidade de vida Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) traduzido e adaptado para a população brasileira. RESULTADOS: A capacidade funcional melhorou a partir do terceiro mês (p < 0,05), o limiar de dor aumentou a partir do sexto mês (p < 0,05), houve diminuição da dor pós-esforço (p < 0,05) e do número de pontos sensíveis (p < 0,05) no nono mês. A intensidade de dor diminuiu no 12º mês (p < 0,05). Com exceção do item "estado geral de saúde" (p > 0,05), os demais domínios do questionário de qualidade de vida melhoraram em diferentes períodos do estudo (p < 0,05). CONCLUSÃO: As pacientes com fibromialgia submetidas ao programa de condicionamento físico supervisionado apresentaram melhora da capacidade funcional, da dor e da qualidade de vida.<br>INTRODUCCIÓN: La fibromialgia es un síndrome crónico, caracterizado por dolor músculo-esquelético generalizado. La posibilidad de atenuación de los síntomas con la actividad física abrió nuevas perspectivas para el tratamiento de esta enfermedad. OBJETIVO: Evaluar el efecto de un programa de condicionamiento físico sobre la capacidad funcional, dolor y calidad de vida de pacientes con fibromialgia. MÉTODOS: Adoptado el método de aglomeración para evaluar 18 mujeres, con edad media de 46,4 &plusmn; 5,8 años, con el síndrome en media hace 10,6 &plusmn; 5,7 años, sometidas a un ano de condicionamiento físico supervisado, predominantemente aeróbico. Al iniciar el estudio y trimestralmente, fueron realizados: test de esfuerzo cardiopulmonar para determinar la capacidad funcional; evaluación de la intensidad de dolor empleando la escala analógica visual; contaje de puntos dolorosos y determinación del límite del dolor a la presión con el uso del algómetro de presión; aplicación de cuestionario de calidad de vida "Medical Outcomes Study 36-Item Short-Form Health Survey" (SF-36) traducido y adaptado para la población brasileña. RESULTADOS: La capacidad funcional mejoró a partir del tercer mes (p < 0,05), la resistencia al dolor aumentó a partir del sexto mes (p < 0,05), hubo disminución de dolor pos esfuerzo (p < 0,05) y el número de puntos sensibles (p < 0,05) al noveno mes. La intensidad de dolor disminuyó al décimo segundo mes (p < 0,05). Con excepción del ítem "estado general de salud" (p > 0,05), los demás dominios del cuestionario de calidad de vida mejoraron en diferentes periodos del estudio (p < 0,05). CONCLUSIÓN: Las pacientes con fibromialgia sometidas al programa de condicionamiento físico supervisado presentaron mejora de la capacidad funcional, dolor y calidad de vida.<br>INTRODUCTION: Fibromyalgia is a chronic syndrome characterized by widespread musculoskeletal pain. Possible symptom attenuation with physical exercise has opened new perspective for treatment. OBJECTIVE: This study aimed to assess the effects of a program of physical exercises (SPPE) on the functional ability, perceived pain and life quality of patients with fibromyalgia. METHODS: A cohort of eighteen female fibromyalgia patients, mean age 46,4 &plusmn; 5,8 years, having the syndrome for 10,6 &plusmn; 5,7 years, were studied along one year of supervised program of predominantly aerobic physical exercises. Patients underwent baseline and quarterly exercise stress tests (EST) to evaluate work capacity; clinical examinations to determine pain intensity through visual analogue scale; tender points count and pain threshold assessment by pressure algometer; as well as interviews using the "Medical Outcomes Study 36-Item Short-Form Health Survey" (SF-36) questionnaire. RESULTS: Work capacity improved from the third month (p < 0,05); pain threshold increased from the sixth month (p < 0,05); post-exertion pain improved (p < 0,05) and number of tender points decreased (p < 0,05) in the ninth month. Pain intensity decreased in the twelfth month (p < 0,05). Except for the "general health perceptions" domain (p > 0,05), all the remaining issues of the SF-36 improved at different periods of the study (p < 0,05). CONCLUSION: Work capacity, pain and life quality of female fibromyalgia patients improved over a 12-month program of supervised physical exercise